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, City of Orono <br /> Zoning Permit Application <br /> Mailing Address: Permit number: � / �O '" �� <br /> �Q�O PO Box 66 Date received: !-oZ-�v -/� <br /> Crystal Bay, MN 55323-00 <br /> ��'e�v��d <br /> Street Address: amount: <br /> � � 2750 Kelley Parkway S� P*��t�� $� <br /> y ; Orono, MN 55356 <br /> F �, <br /> `q kf S H O�� Fax: 952-249-4616 CITY����NO <br /> Main: 952-249-4600 otes: <br /> www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. (Please print.) <br /> Job Site Address: ���s �QJ�/G� � �-�� , D�(�� f �N �JC�.�� <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> ►vame: ��OUT�tVl�yl/ O�Si�N =nrn J oNnrSo�l <br /> Phone: �.`J , �¢ � Fax: <br /> Address: 2 lL Cit : 1 <br /> Contact Person: M J 0 Contact's phone n r (p� .��.451?5 <br /> Email �G� Applicant is: Contractor Homeowner (Circle One) <br /> �Uv'rH►�1E1N 4E . CO1Vl <br /> PROPERTY OWNER INFORMATION: <br /> Name: L11NNE 2A�SMV.S�.,E7�1 � �.1/4N O`CaVA�t�1.L.. <br /> Phone (day): �'-�C'jZ. 41 Z. OS l¢ <br /> Mailing Address: 2$ G Na AJ ZIP: <br /> Email and/or Fax L�l NN� (m�NL �• COM M <br /> Overall Project Description: � �}{ � W �� <br /> CBoXk TYPE OF PERMIT collected whenE ermit is issued <br /> Dock,Commercial $50+engineering review costs <br /> Escrow for erosion control and en ineerin review costs $2,000 <br /> Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs <br /> Minnetonka ermanent dock re uires CUP <br /> �/ Hardcover Permit: Driveway, Patio,Sidewalk,etc.(New or Replacement) No charge <br /> /\, Also re uires is a Minor or Ma or Land Alteration Permit <br /> Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50 <br /> beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback <br /> (also requires Conditional Use Permit) <br /> (Reference: Cltv Code Sections 78-967. 78-1247 and 78-12861 <br /> Escrow for erosion control and engineering review costs As determined b CUP <br /> Land Alteration, Minor(grading,filling or excavating)of 51 to 500 cubic yards beyond the $50+engineering review costs <br /> lakeshore setback OR 50 cubic yards or less within the lakeshore setback <br /> lReference: Cltv Code Sectlons 78-967, 78-1247 and 78-1286I <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs <br /> than 20 cubic yards of imported fill;or are located less than five feet from the property line. <br /> � / Escrow for erosion control and engineering review costs $2,500 <br /> �( lReference: CTtV Code Secflon 78-1405(5.1)1 <br /> �� Retaining Walls which measure more than four feet(from bottom of footings to top of wall) <br /> require a building permit. Tiered retaining walls are considered one wall unless the walls <br /> are se arated b twice the hei ht of the lower wall. <br /> Stairway or Lifts to Lake(New or Replacement) IReference: Citv Code Sections 78-12821 $50+engineering review costs <br /> Escrow for erosion control and engineering review costs $2,000 <br /> Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs <br /> regulated by the zoning code lReference: Citv Code Section 86-661 <br /> Escrow for erosion control and en ineerin review costs 0 <br /> Tree Removal or other vegetation removal within 75 feet of lakes arge. <br /> Reference: Cit Code Sectlon 78-1285 Pre-ins eCtion re uired. <br /> Tem ora Construction O�ce/Trailer associated with buildin ermit <br /> CITY OF ORONO <br /> Updated: May 2015 <br />